Clinical practices to promote sleep in the ICU: A multinational survey |
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| Affiliation: | 1. Gelre Hospitals, Department of Intensive Care Medicine Apeldoorn, The Netherlands;2. Sunnybrook Health Sciences Centre, Department of Critical Care, Toronto, Canada;3. Faculty of Nursing, Midwifery and Palliative Care, Kings College London, United Kingdom;4. Interdepartmental Division of Critical Care Medicine and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada;5. Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom;6. Skane University Hospital, Intensive Care and Perioperative Medicine, Sweden Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden;7. School of Nursing & Midwifery, Queen’s University Belfast, Northern Ireland, United Kingdom;8. University of Copenhagen, Rigshospitalet, Intensive Care Unit 4131, Denmark;9. Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, PO Box 509, NO-4898 Grimstad, Norway;10. Educational Sector, Nursing Services Ministry of Health, Cyprus;11. Rigshospitalet, Trauma Center and Acute Admission, Department of Anaesthesia, Centre of Head and Orthopaedics, Denmark;12. Faculty of Nursing National and Kapodistrian University of Athens, Greece;13. Catholic University of the Sacred Haert, Rome, Italy;14. Faculty of Medicine and Surgery School of Nursing, Cottolengo Hospital, Torino, Italy;15. Asklepios Klinik Schwalmstadt, ICU Schwalmstadt, Germany;p. Department of Nursing, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland;q. Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands |
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| Abstract: | PurposeTo describe sleep assessment and strategies to promote sleep in adult ICUs in ten countries.MethodsMulticenter, self-administered survey sent to nurse managers.ResultsResponse rate was 66% with 522 ICUs providing data. ‘Lying quietly with closed eyes’ was the characteristic most frequently perceived as indicative of sleep by >60% of responding ICUs in all countries except Italy. Few ICUs (9%) had a protocol for sleep management or used sleep questionnaires (1%). Compared to ICUs in Northern Europe, those in central Europe were more likely to have a sleep promoting protocol (p < 0.001), and to want to implement a protocol (p < 0.001). In >80% of responding ICUs, the most common non-pharmacological sleep-promoting interventions were reducing ICU staff noise, light, and nurse interventions at night; only 18% used earplugs frequently. Approximately 50% of ICUs reported sleep medication selection and assessment of effect were performed by physicians and nurses collaboratively. A multivariable model identified perceived nursing influence on sleep decision-making was associated with asking patients or family about sleep preferences (p = 0.004).ConclusionsWe found variation in sleep promotion interventions across European regions with few ICUs using sleep assessment questionnaires or sleep promoting protocols. However, many ICUs perceive implementation of sleep protocols important, particularly those in central Europe. |
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| Keywords: | Intensive care Inter-professional collaboration Sleep Survey |
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